Air medical journal
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Air medical journal · Sep 2006
Sleep and cognitive performance of flight nurses after 12-hour evening versus 18-hour shifts.
Inadequate rest can result in disastrous medical and aviation errors. Using a prospective within-subjects design, this study compared the amount of daily sleep and the cognitive performance in flight nurses working 12-hour evening versus 18-hour shifts during a 72-hour duty schedule. ⋯ Provided adequate daily sleep (at least 7 hours/day) is obtained, we found no difference or decline in the cognitive function of flight nurses working either a 12-hour evening or 18-hour shift during a 72-hour duty schedule. Eighteen-hour duty shifts may be a practical economical means of expanding the period of helicopter site coverage without adversely affecting cognitive performance in medical crewmembers. Actigraphy may be a useful tool for air medical programs that want to objectively assess whether adequate sleep is occurring in individuals working extended (>12 hours) or unusual duty shifts.
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Air medical journal · Jul 2006
Comparative StudyIs air transport faster? A comparison of air versus ground transport times for interfacility transfers in a regional referral system.
Helicopter transport is often considered in an effort to minimize time to critical interventions, such as cardiac catheterization or arterial thrombolysis in stroke patients. However, for interfacility transports, the extra time considerations for helicopter preparation, takeoff, and time to get to the transferring hospital may not offset the slower transport times for local ground ambulances. The purpose of this study was to compare transport times for helicopter with traditional ground ambulance for interfacility transfers within a regional referral system. ⋯ Helicopter transport was faster than ground transport for interfacility transfer of patients from all hospitals studied in our referral system. Under optimal dispatch and transport conditions, the time difference from several hospitals was minimal. For stable patients for whom the only issue is time to critical procedure, it may be reasonable for those hospitals to try ground transport first if timely service is available to transport in that way. Even for those hospitals, helicopter transport should be considered for these patients if ground transport is not optimally available, as well as for patients in whom minimizing time outside of the hospital is a significant consideration, or when transport of such patients impacts emergency medical services availability to the community for a significant time.
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Air medical journal · Jul 2006
Disagreement between transport team and ED staff regarding the prehospital assessment of air medically evacuated scene patients.
To determine the rate of disagreement in assessment of significant illness or injury between air medical transport team assessment and emergency department (ED) diagnosis in patients transferred from the scene of an incident to the ED. ⋯ Despite the numerous difficulties involved in patient assessment, data show that the transport teams accurately evaluated patients in most instances. Disagreements in assessment of injury/illness most often were overassessments.
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Air medical journal · Jul 2006
Sedative use in patients receiving neuromuscular blocking agents from a helicopter flight team.
Cognitive awareness under general anesthetic may occur in up to 0.2% of patients, with approximately twice the risk in chemically paralyzed patients. Patients in emergency and critical care areas frequently receive neuromuscular blocking agents (NMBA), but a recent survey indicated that only 90% to 96% of critical care nurses routinely provide concurrent sedative medications to those patients. We sought to determine the potential for awake paralysis in patients transported by helicopter critical care transport teams and to evaluate for associations with clinical factors. ⋯ Patients receiving NMBAs during transport by helicopter flight teams are at risk for awareness during paralysis. Both practice development and research efforts in this area would be useful.